The purpose of this proposal is to provide Dr. Scott Watson with the means and structure to transition to an independent investigator. The candidate is an Assistant Professor of Critical Care Medicine and Pediatrics at the University of Pittsburgh with training in epidemiology and health services research. His long-term career goal is to optimize the long-term, multi-dimensional patient- and family-centered outcomes of critical illness in childhood. This career award application contains a well defined curriculum in psychometric, quantitative, and clinical research methods, has the institutional support of a leading Department of Critical Care Medicine, and has the commitment of an experienced, successful mentor, Dr. Derek C. Angus. The candidate will study long-term outcomes of an inception cohort of critically ill children at the Children's Hospital of Pittsburgh. [unreadable] [unreadable] A quarter million children aged 1 to 19 years receive care in an intensive care unit (ICU) in the US each year. Although most survive, the survivors are at risk of impairment in multiple domains. The need for additional research evaluating long-term outcomes and functional status after critical illness in children was highlighted at a recent NIH-sponsored conference. [unreadable] [unreadable] The goals of the research portion of this proposal are to determine the incidence and extent of patient morbidity, the impact of illness on families, and risk factors for adverse sequelae following critical illness in children. The candidate will build a stratified prospective cohort of 300 previously healthy children who survive critical illness in the Children's Hospital of Pittsburgh Pediatric ICU. He will perform assessments of 3 primary domains: 1) Functional status and quality of life, 2) Neuropsychologic sequelae, and 3) Family effects. Patients and their families will be evaluated in the hospital and followed for a minimum of 12 months, with evaluations 1,6, and 12 month post-discharge and every 12 months thereafter. Teachers of school aged children will be also be contacted. [unreadable] [unreadable] This study will identify independent risk factors of adverse sequelae related to children's ICU course and will have implications for interventional trials and larger observational studies. It will allow the candidate to obtain skills in multi-dimensional, long-term outcome assessment of critically ill children integral to his development into an independent investigator in pediatric critical care. [unreadable] [unreadable]